Confused About Folate?

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Nutrition & Health:

Confused About Folate?

By LaValle, RD, LD

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At the risk of sounding redundant, I am making folic acid the topic of yet another article. Why? Because making sure you are getting enough folate is one of the most important things you can do for your health. Yet if you read the headlines lately, you may be running scared from folate. Should you take folate or shouldn't you, and if so, how much should you take? Let's clear up some of the confusion.

First, the nomenclature. Folate is the natural form of the nutrient that is found in foods. Folic acid is the synthetic form that is used in many vitamins and for fortification of foods.

Remember, folate is the main nutrient involved in the repair and maintenance of our DNA, and that's why it is involved in everything from cancer, to birth defects, to cervical dysplasia. Studies show that getting enough folate may help protect against several types of cancer, especially colon cancer.

And as Jim's article discussed, taking in adequate folate protects women who consume low to moderate amounts of alcohol from breast cancer. Folate also helps ensure that we have adequate levels of SAMe, which plays a role in mood, protecting against devastating depression. And while many families are debating whether their young daughters should take an HPV vaccine to protect against cervical cancer, it goes completely un-heralded that folate reduces cervical cancer risk significantly.1

Because of a high rate of neural tube defects, the United States decided in 1998 to start fortifying foods with folic acid, and it has been very successful.2 But some studies have found that getting too much folic acid may increase cancer risks slightly in adults, and these are the headlines that have people running scared. Moreover, recent studies which found that folic acid didn't lower risk of heart disease have led to headlines that are implying, "Hey, don't bother with folate."

Some important clarifications about this topic were made in the newsletter from the Harvard School of Public Health, called The Nutrition Source. First and foremost, they point out that the increased cancer risks are slight, and that they are linked primarily to the over consumption of folic acid from fortified foods like cereals and pasta.

The newsletter explained that the reason for the increased health risks may be that at very high intakes of folic acid, the body can't process it all into the active form, and the presence of the unconverted folate prevents uptake of converted folate into the brain and other tissues.

The risks of too much folate from fortified foods though small, deserve further study, but the experts at Harvard aptly point out that the vast majority of the evidence shows that "humans show a lower risk of colon and breast cancer with greater intakes of folate or folic acid," -- not an increased risk.3

Folate from foods poses no health risks, possibly because its absorption and efficacy are enhanced by the presence of other nutrients in the foods. The folks at Harvard recommend taking a multivitamin with 400 mcg of folate, and also making sure to eat plenty of natural food sources of folate.

The multivitamin is especially important if you know you are not eating enough fruits, vegetables, beans, nuts and seeds each day. For people who consume alcohol regularly, they recommend getting at least 600 mcg of folate per day.4 This is especially important for women.

But how are we to get enough folate without getting too much from over-fortified cereals and pastas? It really isn't that hard. As you can see from the list below, 5-6 servings of fruits and vegetables per day should cover it!

Natural Sources of folate:5,6Beef liver, 3 oz (I recommend organic only) -- 185 mcgBlack-eyed peas, 1/2 cup cooked -- 105 mcgSpinach, 1/2 cup cooked --100 mcgGreat Northern beans, 1/2 c. cooked -- 90 mcgAsparagus, 5 spears -- 100 mcgTurnip greens, 1/2 cup -- 80 mcgStrawberries, 8 medium-sized -- 80 mcgBrussels sprouts, 1/2 cup cooked -- 80 mcgBroccoli, 1 cup cooked --100 mcg

References

http://cancerres.aacrjournals.org/cgi/content/full/64/23/8788. Lumley, J, et al. (2001) Cochrane Database Syst. Rev. 3CD001056.

http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/folic-acid/index.html#1.

http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamin-b/index.html.

http://ods.od.nih.gov/factsheets/folate.asp.

http://www.folicacidnow.net/foodSources.html#four.

[Ed. Note: B. LaValle, RD, LD is presently the director of dietetics nutrition at LaValle Metabolic Institute. and her husband, Jim LaValle, R.Ph, CCN, ND have developed the powerful and life-changing Metabolic Code Diet - containing step-by-step, easy to follow recommendations for harnessing optimal metabolic energy and turning your body's chemical make up into a fat-burning furnace.